Premer, Chad T

Premer, Chad T is an individual health care provider with primary practice located at 2601 10Th St , Great Bend KS 67530-4253. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Premer, Chad T can be contacted via phone (620) 792-2020.

Contact Information

Primary practice address
2601 10Th St Great Bend KS 67530-4253
Phone: (620) 792-2020
Fax: (620) 792-2583
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1692 Kansas

Profile Details

NPI number 1104897677
LBN Legal business name Premer, Chad T
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2006
Last updated May 6th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104897677 NPPES
Kansas MEDICAID 200271240A
Kansas Other P00189553

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